Sunday, April 23, 2006

On Hamstrings, History, and Real Concerns

We had just removed Vince Coleman from a game at Shea during the summer of 1991 and I came over to speak with our manager, Buddy Harrelson. Coleman had just injured his hamstring running out a ball to first.
Buddy asked, "is it day-to-day?"
I replied, "there's no such thing as a day-to-day hamstring."
Met training staffs have long dealt with hamstring injuries. Steve Garland and I witnessed Keith Hernandez' and Ron Gardenhire's problems along with Coleman's during the late 1980's. Scott Laurenson seems to have been the fall guy for Jose Reyes troubles a few years ago. It should be interesting to note that both Hernandez and Gardenhire later had back surgery. This shows just some of the potential complications that accompany hamstring tears for athletes well beyond the isolated leg issue, and are among the many things that are going through everyone's minds with respect to Carlos Beltran's current injury.
One must first be advised about semantics. In laymen's terms, we refer to "muscle pulls" as "strains". Strains are essentially a tearing of muscle tissue. So for the sake of discussion here, I will refer to hamstring injuries as "tears".
We essentially sit on the origin of our hamstrings, a group of three muscles which serve to flex the lower leg(kick backwsrds) and extend the thigh. They are attached to both side of our lower leg just below the knee. One small origin is on the thigh. This bone we sit in is called the ischial tuberosity. Its part of your pelvis and thus closely related to your lower back. Tight hamstrings pull the pelvis downward and can create complications for your back.
Conversely back problems can cause hamstring disorders. Consider the position baseball players take in the field between pitches. This odd, hunched over posture, often with their hands on their knees puts undue stress on your back much like sitting at a desk or driving for long periods of time. There is a good reason why your mother always told you to sit up straight. As this position is taken frequently during a players career, it may explain why someone as young as Anderson Hernandez already has a bulging disk.
Thus often a lower back goes along with the hamstring when considering plans of care and histories. Also, the tear needs time to heal. Keith Hernandez hamstring had a big "S" palpable scar in it after his re-injury. And this is where there is cause for caution as an aggravation or reinjury of an already existing hamstring tear can be devastating. Time frames for return can take two months and even longer. Unlike the quadriceps group on the front of the thigh, one cannot play with a hamstring pull. Beltran played with a bad quad all last season, but this is different. A hamstring injury is painful just to stand on.
So along with knowing these dangers, Beltran's recent MRI which indicated inflammation and an old scar doesn't throw caution to the wind. You can be assured the medical staff of the Mets realize all of these things and more. Certainly Beltran does as well.
I must take my old friend, Steve Phillips, to task after he said on ESPNs Baseball Tonight that Beltran's reluctance to play was motivated by not wanting to play hurt again this year and feel the heat from Mets fans. He should know enough to know he cannot possibly know the whole story. He's not there and not part of the staff who's advising all parties concerned. An MRI can't serve as the end all here.
Keith Hernandez lay prone on the training room table in the old Wrigley Field clubhouse in 1988 when the late team physician of the Cubs, Stan London, poked and probed at his hamstring. Mex had gone down two steps after leaving the batter's box as if a sniper had gotten him the day before. He'd injured it slightly in St. Louis at the beginning of the season. London confirmed the severity.
Hernandez looked up at Steve Garland and me and said, "this one's going to be a long one."
Scenes as this aren't what the Mets want repeated.


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